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Safety Day Application for New Coordinators
All applications will be evaluated on:
Community Support
Cost effectiveness for number of participants
Enthusiasm of individual/group applying
Experience of individual/group applying
Contact Information
* Indicates required field
* First Name:
* Last Name:
Organization:
* Street Address 1:
Street Address 2:
* City:
* State/Province:
* Postal Code:
* Preferred Phone:
Ext:
Type:
Alternate Phone:
Ext:
Type:
Fax:
* Preferred Email:
Alternate Email:
Safety Day(s) You Would Like to Conduct
Important Information:
  • The Progressive Agriculture Foundation does not provide monetary grants. This program is designed to train the above named contact to conduct a Safety Day in your community. Note: The contact for this proposed Safety Day can be changed until the training session begins for this Safety Day. Please be sure you have read the questions and answers under the “About Us” tab on our website before proceeding with this application.
  • We typically fund one Safety Day per community/planning group. If funds are available, we support additional Safety Days.
  • The Safety Day location, type of Safety Day, and age of participants: CAN BE CHANGED after you attend training and meet with your planning committee. What you list here is tentative.
  • The number of participants and volunteers: Can be decreased, but CAN NOT BE INCREASED after Safety Days are selected. If your Safety Day is selected and you choose to have more participants or volunteers than you are approved for, there is a charge of $7 per additional person. This fee covers the costs of: a T-shirt, take-home bag, postage, insurance, administrative costs, etc.
  • The number of Safety Day volunteers should not be more than half the number of participants.
  • Community Safety Days are open to anyone who would like to attend, as long as the participant fits your age requirements. School Safety Days are considered part of the school day. You may go to a school or invite one or more schools to come to your location. As the name implies, Classroom-based Safety Days take place directly inside the classroom, requiring less volunteer support. Instead of a one-day program, during a Classroom-based Safety Day the coordinator will make multiple visits to the classroom and highlight a new safety or health topic during each visit. The Safety Zone delivery mode is a condensed version of a PAF Safety Day, which usually occurs in conjunction with another event (i.e., County Fair, Farm Show, Open House, etc.).
After reading the instructions above, please tell us about the Safety Day you would like considered for support. Once you have completed an application for one Safety Day, you will have the opportunity to apply for an additional Safety Day(s).
Location
* Select a Safety Day Year:
* Safety Day Tentative Month:
Location (Facility or School):
* City:
* County:
* State/Province:
* Postal Code:
* Country:
Safety Day Type
Safety Day Type:
* What grades do you plan to reach? Please check all that apply.
Pre-school:
2nd grade:
5th grade:
8th to 12th grade:
Kindergarten:
3rd grade:
6th grade:
College:
1st grade:
4th grade:
7th grade
Don’t Know:
* What ages do you plan to reach? Please check all that apply.
Under age 4:
Age 9:
Age 12:
Age 19 to 21:
Ages 4 to 7:
Age 10:
Age 13:
Age 22 to 65:
Age 8:
Age 11:
Age 14 to 18:
Over age 65:
 
 
 
 
 
 
Don’t Know:
 
* Maximum number of Participants:
* Maximum number of Volunteers:
 
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Add Assistant Coordinator (optional)
Name:
Mail Address:
Email:
Phone:
If you cannot locate a coordinator or need to add a new individual, please contact us at safetyday@progressiveag.org.
Tell us How You Will Involve Others from Your Community?
* Tell us how you will involve others from your community (include businesses, organizations, and key individuals that you plan to collaborate with).
Tell Us About You and Your Community
*Tell us your past experience with Progressive Agriculture Safety Days® or other youth-related safety events/camps/etc.
 
How did you hear about us? (Check all that apply)
Website
Social media (Facebook, Twitter, etc.)
Publication or Magazine
Conference/Convention/Farm Show
Safety Day
Other
Special Requests
Briefly tell us any special requests you have for your Progressive Agriculture Safety Day®.
Agreement
* I understand that this application will be reviewed by a selection committee. If approved and we accept support of the Progressive Agriculture Safety Day® program, I agree that the person who coordinates the Safety Day will attend a training session, and that we will comply with all requirements of the program.
Date: 05-30-2024
If you disagree, please call us at 1-888-257-3529
 
 
PLEASE NOTE: Applications are usually reviewed and decided upon by the beginning of September. If you do not receive either an acceptance or denial email by September 15th, please call us at 1-888-257-3529 to inquire about the status of your application.
 
 
To submit your application click Submit.
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